A case of acquired zinc deficiency in a very low birth weight infant caused by a low zinc concentration in breast milk

We report a breast-fed very low birth weight infant with zinc deficiency because of a low zinc concentration in his mother's breast milk. He was born at 29 weeks of gestation weighing 1245 g. From the age of 2 months, scaly erythematous plaques appeared on his face and external genital region. Topical corticosteroids and antibiotics were prescribed but the symptoms did not improve. Alopecia and diarrhea were not observed. He had been fed only breast milk before being examined. Examination showed a low serum zinc level of 17 μg/dL (65∼110 μg/dL). His mother's serum zinc level was normal at 93 μg/dL (65∼110 μg/dL), but the zinc level in her breast milk was low at 32 μg/dl (110∼270 μg/dL). Based on these findings, this case was diagnosed as having acquired zinc deficiency due to a low maternal breast milk zinc concentration. In general, the treatment for zinc deficiency is supplemented with zinc sulfate. In this case, however, weaning the infant from his mother's milk onto mixed nutrition was sufficient to improve the dermatitis. No recurrence has been observed.